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Obese, pregnant. Fetus not visible. History of PCOS and miscarriages. Given medication to expel the fetal sac. Advice?

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I am approx. 7 weeks pregnant. I have been dealing with a lot of family, work stress. I have suffered 2 miscarriages before this pregnancy. On the doctors visit I had on Saturday, the doctor measured the fetal sack and said it was about the size of that of a 7 week old embryo, but we could not see the baby. I am an obese woman weighing 324 pounds due to PCOS. The doctor mentioned that my BMI could make it difficult to see the baby. I also reported to the doctor that I had anal bleeding, always bright red, NEVER vaginal. She did not check it but passed it off as hemrhoids. She said that its not a viable pregnancy and gave me pills to go home with to expell the sac. I want to know can she be wrong? Could the baby be obscure due to my weight?
Posted Sat, 21 Apr 2012 in Pregnancy
Answered by Dr. Rhea Chanda 59 minutes later

Thanks for the query.

In your case, obesity may sometimes make it difficult for the ultrasound probe to get through.

However, nowadays, the high end probes have a higher sensitivity and the clarity of the ultrasound is much better. Normally, by 7 weeks, the fetal cardiac motion is present and its visible on ultrasound. Sometimes follow up scan may be advised after a week so to see if there is any late development.

You can wait for another week and repeat an ultrasound. Even then, if there is no cardiac motion, then this wouldn't be a viable pregnancy. In such a case, termination is advised.

It is rarely that fetal cardiac motion develops later than 6 weeks.Hence at present,the most you can do is get another scan after a week, but be mentally prepared for termination, if the results are the same.

Transvaginal ultrasound is very sensitive and obesity shouldn't cause a problem. Your anal bleeding is probably due to hemorroids and may get aggravated during pregnancy.

I hope, I have answered your query. Please accept my answer in case you have no follow up queries.


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